- The management model must be adapted to the geographic context.
- Material and human resources need to be improved.
- Patient-centered care is effective.
The healthcare systems of Latin America and the Caribbean face a significant challenge: improving diabetes prevention and ensuring adequate medical care for the population. The organization of healthcare systems is one of the environmental factors surrounding the patient that can have the greatest impact on disease management. Although effective recommendations for improving public health regarding diabetes have existed for years, they are primarily designed for high-income settings. The CEAD project (Contextualizing Evidence for Action in Diabetes) has investigated the unique characteristics of public health systems in middle- and low-income regions to propose actions that positively impact the quality of life of those affected.
The prevalence of diabetes and its associated mortality rates are rising in Latin America and the Caribbean, which account for 80% of the affected population. The World Health Organization (WHO) and the International Diabetes Federation, both leading entities in this field, recognize that combating diabetes cannot rely on a one-size-fits-all model. Adapting management models to the realities of each geographic area is therefore a complex but essential task. The systematic review conducted as part of the CEAD research project highlights that successfully managing diabetes largely depends on factors beyond the patient’s control. In other words, it depends on their environment. Some of the most critical factors include the healthcare system serving them, the physical environment in which they live, and the social circles with whom they interact.
In most countries in Latin America and the Caribbean, patients themselves bear the costs of medical equipment and medications. For patients with type 2 diabetes, monitoring blood glucose levels is recommended at least once a day, often accompanied by insulin administration. Additionally, diabetes is associated with other conditions, such as hypertension or circulatory problems, which may require additional medication.
Some of the more abstract aspects of the healthcare system are also important for improving medical care for diabetes. Having multidisciplinary profiles on the team allows care to be approached from different perspectives, an added value not found in teams made up of professionals from the same medical specialty.
Patient-centered care has also proven to be significant. This care approach involves understanding and responding to the individual needs of the people being treated. It is informed by scientific knowledge and guided by ethical principles. CEAD research has shown that this approach is more effective in managing diabetes than recommendations aimed at the general population.
The systematic review also concludes that paternalistic attitudes and vertical communication by healthcare workers can be a barrier. Promoting two-way communication with patients and strengthening the role of nursing staff are proposed as effective alternatives.

The CEAD team also highlights that healthcare in the analyzed regions focuses more on rehabilitation and treatment than on prevention or early diagnostic phases. Therefore, it recommends directing efforts toward improving early detection of type 2 diabetes.
From hiring personnel and acquiring material resources to the more abstract aspects of management in healthcare centers, along with ensuring universal access to medication and medical equipment for those affected, improving diabetes care requires changes that meet the scale of the challenge. Reversing the pathological trends in Latin American and Caribbean societies depends on actions beyond the control of those affected. Adapting diabetes healthcare management through public policies is an essential task where governments have a significant role to play.